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c. ! ' t '•�- lax.C - '': '.S3-'v <br /> SAN JOAQUliN COUNTY ; <br /> PUBLIC HEALTH,.-:SEIVICES <br /> ~ENVIRONMENTAL; FiI;ALTH=DIVISION <br /> k24Y 4 PUBLIC . RECORDS= RELEASE. APPLICATION' <br /> = <br /> { <br /> Ga /1I�PLICAN'i' �+ 'PHONE NO -y <br /> y =t ADDRESS <br /> AGENCY NAME ° , tr PHONE <br /> NO, <br /> ADDRESS <br /> ss �<��'`yJ.. #'�..�#4•�,�#'*�*�.�''A.'�'*''A.{�.�'�#'_'A•*.'k*'*'A'#'�'k'k#�''k#.'R'A.'A'#'•�'R_#'#`-•k•k#`i'*'A•#'#`;*,'A�.'A''A.•k�.'A'.k'A'*#'M•k�' �j-f�`.,. <br /> Y <br /> - PROGRAM- <br /> OR ' <br /> � ^ FULL ADDRESS <�, BUSINESS NAME/ <br /> ` �` FACILI'T'YTYPE OF FILE , �`�. <br /> IVf , <br /> t <br /> THIS NOTICE IS SUBJECT TO THE REQUIREMENTS IDENTIFIED IN THE PUBLIC HEALTH <br /> ' SERVICES/ENVIRONMENTAL HEALTH DIVISION (EHD) POLICY #94-007, ORDINANCE CODE,OF�{� <br /> SAN JOAQUIN COUNTY, EHO FEE AND SERVICE CHARGE RESOLUTIONS, STATE WATER'rCODE. � < <br /> GOVERNMENT CODE AND THE EVIDENCE CODE. <br /> - 1 �► MAXIMUM OF TEN 110). PREMISE ADDRESSES PER REQUEST, <br /> PUBUC FILES/RECORDS REVIEW IS BY APPOINTMENT ONLY. APPOINTMENTS ARE PROCESS•, <br /> 1` EO BY CALLING t�091468-3420. OFFICE HOURS FOR APPOINTMENTS ARE SCHEDULED MONDAY. <br /> k. . AN <br /> _ <br /> ;. THRU FRIDAY EXCLUDING HOLIDAYS, 8:00 AM TO 12:00 NOON AND'1:OOTO 4 30 PM' �� <br /> 3. A PUBLIC FILES/RECORDS RELEASE APPLICATION (PRRAI IS REQUIRED. <br /> fh.. yi'R"y,�' �. i :- _3\... K;y •^'• ._�1..•: .. x`.. ♦ tcF.v> ,('tW'_i, . <br /> 4. PUBLIC FILES/RECORDS NOT RETURNED. IN THE SAME CONDITION-AS RECEIVED WILL_BE <br /> CORRECTED BY THE EH0'STAFF AT THE EXPENSE OF THE APPLICANT. THIS ADDITIONAL w" - <br /> < Of,('PAYMENT. <br /> WILL <br /> ,BE BILLED <br /> THE.APPLICANT FPAYMENT. (SEE EHD POLICY 94- 007) <br /> ••<F ' - - - -t .•l yah -i F •� .. _�'1 .,.. e _ ..•1• <br /> 5. ORIGINAL PUBLIC FILES/RECORDS SHA x 0 BE REM FROM.THE EHO PREMISES <br /> „ z. <br /> M . <br /> ♦♦ <br /> ' •••♦••♦i•ia•i� ♦�• ' • 4 ••• • ♦♦♦•• •• • •♦•••♦♦♦♦•�♦ •••♦ ♦♦♦♦t•♦a♦. . <br /> 3 ` � . . - DATE <br /> SIGNATURE OF'APPLICA <br /> SIGNATURE OF RELEASING OFFICIAL DATE STM <br /> EH 00 14 (REV 9/961 <br /> ti.;: +r, - 1'�r ae'L'<•: ;+-..�!er3�Yf. i�. ;Lf'ie` <br />